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Personal Disord. Author manuscript; available in PMC 2015 April 28.
Published in final edited form as:
Personal Disord. 2015 April ; 6(2): 204–205. doi:10.1037/per0000123.
The Misnomer of Impulsivity: Commentary on “Choice
Impulsivity” and “Rapid-Response Impulsivity” Articles by
Hamilton and Colleagues
Melissa A. Cyders, Ph.D.
Department of Psychology, Indiana University – Purdue University, Indianapolis
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The pair of articles presented by the International Society for Research on Impulsivity
address the definition of, recommendations for, and future directions for research on two
constructs related to impulsivity: Choice impulsivity (CI) and Rapid Response Impulsivity
(RRI). As has been well-documented elsewhere, the construct of impulsivity encompasses
multiple different dispositions to rash action, including, but not limited to, acting without
thinking, seeking out new or thrilling sensations, excitability, behavioral activation, motor
impulsivity, cognitive impulsivity, and distractibility (e.g., Depue & Collins, 1999;
Whiteside & Lynam, 2001). Measurements of these numerous constructs have included
many different self-report questionnaires and behavioral laboratory tasks (for two previous
reviews, see Cyders & Coskunpinar, 2011, Dick et al., 2010).
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Impulsivity is the most frequently included criterion in the Diagnostic and Statistical Manual
(DSM-5; APA, 2013) and is thought of as a prime transdiagnostic endophenotype of risk for
a wide range of clinical disorders (see Cyders, Coskunpinar, & VanderVeen, in press,
Verdejo-Garcia, Lawrence, & Clark, 2008). However, many of these “impulsive” constructs
describe different behavioral tendencies. These separate impulsivity-related constructs have
varying levels of clinical utility in predicting clinical outcomes (see Smith et al., 2007). As
described by Smith, Fischer, and Fister (2003), aggregating across measures assessing
different aspects of impulsive behavior (as would be the case if measures of CI were
combined with measures of RRI) would result in a lack of construct homogeneity (see
Strauss & Smith, 2009), which could (1) lead to vague conclusions about the active
components of the construct’s predictive value (i.e., what is actually explaining the effect on
the clinical outcome), (2) obscure existing relationships with outcomes of interest, and (3)
lead to inconsistencies across studies and a stalemate in the accumulation of scientific
knowledge. A review of the research literature on impulsivity certainly suggests that these
three outcomes are occurring and slowing the progress of science.
Therefore, the attempt to define clear, unidimensional constructs related to impulsive action
is an important one undertaken by these authors. Much of the work in disaggregating the
trait of impulsivity has occurred with self-report measures; however, self-report assessments
are limited by many biases and are less translationally applicable. The pursuit of defining
Author contact information: Melissa A. Cyders, Ph.D., 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, (317) 274-6752,
[email protected].
Cyders
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clear behavioral impulsivity constructs will lead to more reliable research findings, a better
understanding of translational approaches, and cumulative progress in science. If CI is
related to an outcome, but RRI is not, for instance, combining these two measures into one
construct would obscure meaningful relationships. In this case, we are truly combining
apples and oranges – true, they are both fruit, but they sure taste different.
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A previous attempt to disaggregate behavioral impulsivity tasks has been undertaken (Dick
et al., 2010), which proposed five different types of cognitive processes thought to represent
the construct of impulsivity: (1) being able to suppress dominant or automatic responses
(prepotent response inhibition; most similar to RRI proposed by the current pair of articles),
(2) the ability to avoid interference from task-irrelevant information (resistance to distractor
interference), (3) the ability to resist memory intrusions of no longer relevant information
(resistance to proactive interference), (4) the ability to delay responding in the face of a
larger reward (delay response; most similar to CI proposed by the current pair of articles),
and (5) the ability to accurately judge time passages (distortions in judging elapsed time).
Clearly the Dick and colleagues (2010) disaggregation includes more facets of behavioral
impulsivity than the current authors include; research is needed to validate the groupings of
these constructs, determine the appropriate or best-fitting number of groupings, and
determine the differential clinical utility of these groupings.
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However, what is clear from previous work is that correspondence among these separate
“impulsivity” constructs is weak at best. In fact, separate constructs share very little variance
and overlap, suggesting that the term “impulsivity” is a misnomer and that these separate
tendencies are assessing separate, through related, constructs (Cyders & Coskunpinar, 2011;
Smith et al., 2007). Even the current authors suggest that CI and RRI are weakly related; the
persistence in referring to these separate constructs as “impulsivity” is problematic, as this
suggests a relationship that is likely not there and does not offer the precision to clearly
describe the specific tendency that is being assessed. In self-report conceptualizations, we
have found that there is no overarching “impulsivity” trait that explains interrelations among
the traits (Cyders & Smith, 2007); it is better to think of them as separate and distinct
tendencies. This is likely also true for behavioral conceptualizations of impulsive action.
Until we stop using the term “impulsivity” to refer to a multitude of different tendencies, all
of which have different magnitudes of relationships with clinical outcomes and are not
highly related to each other, we will continue to muddy the water, mask existing effects,
misunderstand existing research, and fail to move forward past the question of Is impulsivity
related to psychopathology and how? After so many years of impulsivity research, we could
be farther, and this increased specificity in our operationalizations and measurement will
help.
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The current articles make clear suggestions on how to use measures of CI and RRI in
research settings, which will help to standardize procedures and advance the field. Given the
lack of overlap between these constructs and impulsivity-related traits (see Cyders &
Coskunpinar, 2011), I recommend that researchers interested in human impulsivity include a
trait measure of impulsive tendencies in research methods. Many of these measures are not
burdensome on participants and can offer a richer picture of general tendencies toward
impulsive behavior that occurs outside of the laboratory. It is important that such measures
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assess separate unidimensional aspects of trait impulsivity, such as the one my colleagues
and I have developed (The UPPS-P Impulsive Behavior Scale; Lynam et al., 2006), although
others exist as well (e.g., The Barratt Impulsiveness Scale; Patton, Stanford, & Barratt,
1995).
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One remaining question is if impulsive tendencies are implicated in such a wide range of
clinical disorders, what is the role of these tendencies in the etiology of these disorders or
their treatment? Are CI and RRI (as well as other constructs) mere symptoms of the
disorders or do they represent fundamental dysfunction in neurobiology that underlie the
disorders? Modifying these tendencies is often a focus of therapy. Take, for example, an
individual who has lost custody of his or her children due to drug abuse. Therapy could
focus on resisting a smaller, immediate reward (drug high) in exchange for a larger, delayed
reward (regaining custody of his/her children). Does modifying this CI tendency generalize
to other domains? Does this help to treat the disorder or just the symptoms? The clinical and
research communities require a better understanding of how treating or modifying
impulsivity can affect clinical disorders and their underlying biological mechanisms.
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In conclusion, only by separating and clearly defining unidimensional impulsivity-related
constructs can we better understand the role of these tendencies in clinical disorders. This
pair of articles offers clear guidance to standardize the measurement and use of CI and RRI
in future research studies that will help to advance the cumulative nature of our research
findings. Continued work to determine the content domain of these tendencies (e.g., is two
enough?), the relationship of these tendencies with other impulsivity-related constructs, and
the effect of modifying these tendencies on subsequent clinical symptomatology will lead to
clinical science gains and improvement in identification, prevention, and intervention
strategies.
References
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APA. Diagnostic and Statistical Manual of Mental Disorders-5. American Psychiatric Association;
Washington, DC: 1994.
Cyders MA, Coskunpinar A. Measurement of constructs using self-report and behavioral lab tasks: Is
there overlap in nomothetic span and construct representation for impulsivity? Clinical Psychology
Review. 2011; 31:965–982. [PubMed: 21733491]
Cyders, MA.; Coskunpinar, A.; VanderVeen, JD. Urgency – a common transdiagnostic endophenotype
for maladaptive risk-taking. Invited chapter in press. In: Zeigler-Hill, V.; Marcus, D., editors. The
Dark Side of Personality. American Psychological Association; in press
Depue RA, Collins PF. Neurobiology of the structure of personality: Dopamine, facilitation of
incentive motivation, and extraversion. Behavioral and Brain Sciences. 1999; 22:491–517.
[PubMed: 11301519]
Dick DM, Smith G, Olausson P, Mitchell SH, Leeman RF, O’Malley SS, Sher K. Review:
understanding the construct of impulsivity and its relationship to alcohol use disorders. Addiction
biology. 2010; 15:217–226. [PubMed: 20148781]
Lynam, DR.; Smith, GT.; Whiteside, SP.; Cyders, MA. The UPPS-P: Assessing five personality
pathways to impulsive behavior. West Lafayette, IN: Purdue University; 2006.
Patton JH, Stanford MS. Factor structure of the Barratt impulsiveness scale. Journal of Clinical
Psychology. 1995; 51:768–774. [PubMed: 8778124]
Smith GT, Fischer S, Cyders MA, Annus AM, Spillane NS, McCarthy DM. On the validity of
discriminating among impulsivity-like traits. Assessment. 2007; 14:155–170. [PubMed: 17504888]
Personal Disord. Author manuscript; available in PMC 2015 April 28.
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Smith GT, Fischer S, Fister SM. Incremental validity principles in test construction. Psychological
Assessment. 2003; 15:467. [PubMed: 14692843]
Strauss ME, Smith GT. Construct validity: Advances in theory and methodology. Annual review of
clinical psychology. 2009; 5:1.
Verdejo-García A, Lawrence AJ, Clark L. Impulsivity as a vulnerability marker for substance-use
disorders: review of findings from high-risk research, problem gamblers and genetic association
studies. Neuroscience & Biobehavioral Reviews. 2008; 32:777–810. [PubMed: 18295884]
Whiteside SP, Lynam DR. The five factor model and impulsivity: Using a structural model of
personality to understand impulsivity. Personality and individual differences. 2001; 30:669–689.
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Personal Disord. Author manuscript; available in PMC 2015 April 28.